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I Want to Give a Gift/Make a Pledge to Annual Fund 2012
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*
) are required.
First Name:
*
Last Name:
*
Constituency:
*
Parent
Alumnus/Alumna
Parent/Alum
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Former Faculty/Staff
Grandparent
Parent of Graduate
Friend
If alumnus/alumna, class year:
*
Home address:
*
Apt/suite
City/State/Zip:
*
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Home Phone:
*
Work Phone:
*
Email address:
*
I want to:
*
Make a Pledge to Annual Fund 2012
Pay a Previous Pledge to Annual Fund 2012
Make a New Gift to Annual Fund 2012
Comments regarding my gift to Annual Fund 2012:
Please note: Annual Fund 2012 closes on June 30, 2012.
For more information, please contact Melissa Parento at 718-432-3456 or
send an email.
Today's date:
May 20, 2012
Amount of pledge:
*
Amount paid today:
*
Credit Card Type:
*
Visa
Master Card
American Express
Card Number:
*
Card Security Code:
*
Expiration Date:
*
Name on Card:
*
Use Home Address for Billing Address
Billing address:
*
Apt/suite
City/State/Zip:
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Note: Since you received no goods or services in consideration of this gift, your contribution is fully deductible to the extent allow by law. Upon the processing of this gift made online, you will receive a formal written acknowledgement, which satisfies IRS requirements for documentation of tax deductible contributions. We recommend that you retain the letter as proof of your contribution.
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